Anesthesia explained by ID Hospital specialists

Anesthetia Q&A with dr. Lee Hye Jin 

Anesthesia medication like propofol has been a social issue for several years due to the negative effects of misusing it, and people used to think of it as of a drug rather than sleeping anesthetics. ‘Propofol addiction’ and ‘propofol death’ extreme cases hided the positive side of medical use.

But is it really dangerous? ID Hospital anesthesiologist Dr. Hyejin Lee and ID Hospital head dr. Park Sang Hoon are explaining details about sleeping anesthetics.

Sleeping Anesthetics Used for  anesthesia (Sedation): Midazolam, Ketamine and Propofol

Sleeping anesthesia is in fact a sedative therapy. It means that the patient is somewhat aware of  physical stimulation or speech. Anesthesiologists divide sleep anesthetics into three categories. Lee Hyejin, anesthesiologist at ID Hospital, said, “Midazolam, ketamine, and propofol are all types of sleep anesthetics. Anesthesiologist needs to consider each of the pros and cons  depending on the patient’s condition”.

 Types of Sleep Anesthetics

▶ Midazolam

A drug belonging to the benzodiazepine family, which has a calming effect by reinforcing the action of inhibitory neurotransmitters in the brain. Midazolam induces sleepiness, decreases anxiety, and causes a loss of ability to create new memories. So even though you feel pain during the surgery, you won’t remember it. Cardiovascular inhibitory effect is small, but midazolam can reduce blood pressure, so it takes a long time to recover.”

▶ Ketamine

Ketamine is a general anesthetic that has an analgesic effect injected into vein or muscle. It induces a trance-like state and increases calming effect if combined with midazolam or propofol. It’s easier to maintain the airway due to lesser respiratory depression  has the advantage of analgesic action. Disadvantages include increased cerebral blood flow and cerebral pressure, elevated heart rate and blood pressure, hallucinations, delusions, and nightmares.

▶ Propofol
Propofol is a general anesthetic drug that is administered directly to veins and has the fastest effect. It is used for anesthesia during surgery or examination, or to calm a patient using a ventilator. Usually it is s an anesthetic for sleeping endoscopy, simple procedures, and plastic surgery. Propofol anesthesia induction and anesthesia recovery are faster than other anesthetics. If the patient is healthy the anesthetic is metabolized in the liver and then leaving the body with urine. Unlike other anesthetic it doesn’t cause nausea or vomiting.

Is it safe to use for medical purposes? Does it cause addiction or death?

Lee Hye-jin said, “Proportol is a problem that can be summarized as addiction (abuse) and death due to respiratory depression. Propofol causes addiction in some patients because it gives comfort and refreshment after a good night’s sleep without nausea, headache and discomfort after anesthesia, leading to misuse. High doses can lead to apnea due to respiratory depression and death, ”she added. However, it was clearly emphasized that the problem was indiscriminately misused, not for medical purposes under the supervision of anesthesiologists.
Propofol is a psychotropic drug, so it must be used only for the medical purpose under the supervision of the anesthesiologist. In addition, it is important to adjust the dose for each patient in consideration of age, weight and medical history. If you have a history of sleep apnea, medications or food allergies, you should tell your doctor in advance.

If you are allergic to soybeans, it is important to properly consider the usage of propofol.

Propofol is a drug that contains soybean oil and egg lecithin, so if you are allergic to soybeans, peanuts, or soybean oil, you should be careful. Dr. Hye-jin Lee said, “It is possible to use propofol for general egg allergy patients, but it is safe to avoid it if there is a history of anaphylaxis (a severe allergic reaction that can lead to death from laryngeal edema, dyspnea, or low blood pressure shock). If you have a propofol allergy, mild symptoms may improve with urticaria, but severe death can result from dyspnea and hypotension shock. ”

Check this before choosing a clinic for surgery!
– A clinic has in-house anesthesiologist
– If not,  who is observing patient’s condition during anesthesia
– A clinic has a medical staff and equipment appropriate for the first aid in case of an emergency
– Which anesthetic does clinic use

What about the dose?
Dose adjustment considering patient’s condition is very important. ID Hospital provides propofol sensitivity pre-examination to ensure safety of anesthetics medical use and to reduce patient’s risk and anxiety.
Dr. Sang-Hoon Park, MD, said, “It is very easy to control propofol level during anesthesia and then recover from it. But as it is classified as a drug product, it must be used only under a specialist’s supervision. It is important to know the propofol sensitivity of the patient in advance through medical examination.

You can read more about ID Hospital anesthesia system here.

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